Confessions of a Psych Mental Health NP
Many of my clients are afraid of taking medication. In fact, local therapists refer to my practice as the place to go for their clients that don’t want medication but need it. We take client fears very seriously. Medication is a powerful tool. However, it is not without risks. We always walk gently with clients because, ultimately, they are in charge of their hearts and minds. Pregnant women, especially, are often very fearful of antidepressants and anti- anxiety medications. Understandably, most people don’t want to expose their developing baby to anything that could potentially harm it. Unfortunately, uncontrolled anxiety or depression is actually a risk to the baby. The Nurse Practitioners at Nurtured Well have a combined 20 years of experience. I personally have 17 years with the last 5 years focused on women’s mental health. Therefore, it may surprise you that I, too, was terrified to take medication.
Common Fears About Medication
It will Change My Personality.
This is the top concern I hear. Sometimes, people do feel more flat on medication. However, this means that it is either the wrong medication or the dose is too high. When medication is correct, you will feel your best version of you.
I’ll Go ‘Crazy”.
I always find this one interesting. The good news is that you won’t. The one thing that can happen if antidepressants induce mania in someone with undiagnosed bipolar disorder. You can learn more about bipolar here. If, for any reason, you feel you might have it, tell your provider. Conversely, a good provider will spend enough time evaluating you to make sure it’s not a possibility. Otherwise, the medication can not make you lose your mind. Periodically, some people will feel worse on certain medications. However, the issue may be that particular medication, not all antidepressants.
I’ll Gain Too Much Weight.
Weight gain is a side effect of many antidepressants. Upwards of half of all people will report some weight gain on them. However, some antidepressants are much more likely to cause weight gain than others. It’s important to talk with your provider about this.
I’m Pregnant, I can’t take Antidepressants.
Sadly, this myth continues despite many public health campaigns correcting it. I’ve written extensively about medication in pregnancy as well as untreated mental health in pregnancy. The TLDR version is, both pose risks. However, we know that Selective Serotonin Reuptake Inhibitors (SSRIs) such as Zoloft, Prozac and Lexapro do not cause miscarriage or birth defects. We also know that moderate to severe depression or anxiety can have long lasting emotional, learning, and behavioral effects in children exposed in utero and postpartum. This isn’t to blame any mother. It is important to educate, though.
My Personal Journey With Medication.
As stated above, I specialize in women’s mental health. However, I was just delving into it when I was pregnant with my second child. Overall, it was a rather stressful time in my life. I was in a job that was not working out. Additionally, I had very limited childcare. Because the job was not paying what I expected, I had taken a second job so I worked 40 hours a week with 24 hours of care for my then 2 year old. I simply was not doing well. However, I was paralyzed with fear around taking an antidepressant.
I muddled through, using my other coping skills. However, I really regret not getting more help. Exercise, meditation, and seeing a therapist were helpful but I also needed the medication. I honestly can’t even remember what I was afraid of , I just couldn’t do it. I certainly was still a loving mother to my older child, however I was not at my best. Once she was born, I finally started medication. I even nursed her while on it until she was 2.5 years old! The medication really helped. Especially since I was not able to access all my coping skills with two kids. If I could go back in time, I would definitely have started when I needed it- during my pregnancy. I share this only to normalize fears– whether you’re pregnant or not– around medication.
Many women fear taking an antidepressant. Common concerns are that it will change your personality, worsen symptoms, cause weight gain or can’t be taken while pregnant. Of course, your concern may be different. I encourage you to find a caring provider who will take time to explore your fears so you can get the help you need.
Need help? We are dedicated to Women’s Mental Health.
About the Author: Sharon P. Fisher, MS, PMHNP-BC, PMH-C is the founder of Nurtured Well LLC, a women’s boutique mental health practice serving all of Maryland.